A lot of non-surgical treatments for Dupuytren's disease have been used over the years: radiation therapy, ultrasound, steroids, inferferon, antigout medicines, dimethyl sulfoxide and vitamin E cream. There is limited or no clear evidence of them working.

Below is a review of non-surgical treatments that have a scientifically proven effect and have been approved for the treatment of Dupuytren's disease.

Intralesional injection therapy1

An intralesional treatment works by injecting a medical substance directly into a body part that is affected by a disease (called a lesion). In the case of Dupuytren's disease, it is the cord that is causing the fingers to bend. The substance used in a intralesional treatment can dissolve the collagen to break down the cord. The injection is then followed by a procedure the next day during which the finger is extended by the doctor, breaking the cord. In some cases the cord breaks on its own, meaning that the extension procedure is not needed. This treatment does not require you to stay in hospital, neither is an anaesthetic needed.

A MP joint, or metacarpophalangeal joint. These are the joints that are located just below the fingers. It is often the ring finger that is affected by a Dupuytren’s cord, as shown by the picture to the left. The picture above shows a Dupuytren’s cord in a MP joint that is being treated by an intralesional treatment.

Percutaneous needle fasciotomy2

This technique uses a needle to cut the cord. The needle is inserted into the palm or fingers to cut (section) the tissues in the palm. The Dupuytren's cord is sectioned by moving the needle in a sawing motion. This movement is repeated several times. The goal is to break the cord so the finger can be straightened. This technique can be carried out under local anaesthetic and may be performed in a day surgery or doctor’s office with no need to stay in hospital.

All treatments have different side effects. Surgery generally have a longer rehabilitation period than non-invasive treatment options. And while all treatments can improve the contracture, none of them can cure the disease. The contracture may also reoccur in the future.

Sources:

  1. Hurst LC et al. N Engl J Med. 2009;361:968–979.
  2. Diaz et al. Hand Clin. 2014;33-38.